Bone And Joint Conditions

The bones, joints and muscles are prone to wear and tear, strains and sprains. However some symptoms can indicate a more serious underlying condition of the heart or cardiovascular (circulation) system.

JOINTS

Joint pain but no redness: Joints gradually over a number of years become painful, but there is no redness; joints are stiff after rest but improve when you start moving; there may be a creaking sound in the joint when you move or the joint suddenly gives way when you put pressure on it; typically it appears in the knees, hips and hands. These are signs of osteoarthritis, also known as 'wear and tear arthritis'.

Joint pain and swelling

The joints are painful and become swollen and are particularly stiff in the morning; the fingers, wrists and balls of the feet are most vulnerable; symptoms are progressive so they become worse over the years; you may also experience tiredness, depression and a general feeling of unwellness and irritability. These are all signs of rheumatoid arthritis, an inflammation of the joints which over time can damage nearby bones and ligaments.

Joint pain with rash

Joint pain which flares up and then subsides; skin rash - typically a butterfly shaped rash across the nose; increased sensitivity to light, fever, tiredness, weight loss and hair loss. These are all signs of lupus. Lupus typically affects women of childbearing age and it is more common in women of Asian or Afro-Caribbean origin.

Joint pain with scaly skin

The joints are swollen, with symptoms ranging from mild to severe. The skin and nail show signs of psoriasis (dry, flaky or red skin and the nails become yellowish and separate from the nail bed). Typically the knees, elbows and toes are most affected. Joint pain and skin problems flare up together. This is called psoriatic arthritis. See, arthritis and arthritis pictures.

Your joints ache all over the body; your salivary and tear glands do not function correctly resulting in a dry mouth and eyes; there may also be tiredness and dental problems. These are signs of Sjogren’s syndrome, the second most common autoimmune disease after rheumatoid arthritis. It typically affects women between the ages of 40 and 60.

Joint pain and feeling sad

All over joint pain with no obvious cause; feeling sad for no reason and you can't shake the feeling; headaches and easily irritated. See effects of depression.

HANDS

Tingling Pain in the hand which can radiate to the forearm; there may also be numbness, weakness in one or both hands. Symptoms are often worse at night. You may have carpal tunnel syndrome which is caused by entrapment of the main nerve in the hand called the median nerve. It can be caused by repetitive movements like typing on a keyboard or by wrist fractures, fluid retention due to pregnancy or weight gain. Occasionally it is a sign of hypothyroidism.

Shaky hands with dislike of heat

Shaky hands or fingertips, unexplained weight loss even though you may be eating more, heart palpitations, you get hot more easily than you used to; you sweat more easily and experience lighter periods than normal. These are all signs of an overactive thyroid. See, hyperthyroidism.

Shaky hands after skipping a meal

Your hands start to tremble if you skip a meal, you may also feel slightly sweaty or dizzy. Eating a snack cures the symptoms within a few minutes. This is a sign of low blood sugar. For most people it is not an indication of anything serious, it is the body telling you that it likes to be fed little and often - you may notice trembles occur when you are physically more active than normal. If it occurs regularly and you also display symptoms of diabetes, ask your doctor to test for diabetes. If you do have diabetes and your hands shake it is a sign of hypoglycemia, indicating you may need to manage your insulin injections/medications better or stop skipping meals.

Numbness and increased thirst

You could have prediabetes. While there are no obvious signs of prediabetes, you may suffer milder versions of diabetes symptoms including: Tingling or numbness in the hands for feet; increased thirst; frequent urination; generally feeling exhausted; you might also suffer recurrent yeast infections or have bruises which are slow to heal. See prediabetes.

Finger joints look bony

Your finger joints start looking bony or knobbly (Heberden's or Bouchard's nodes); the joints are stiff first thing in the morning; fingers start cracking when you move them (crepitus); pain gradually over a number of years becomes more severe, even at rest and during the night. These are all signs of arthritis. See, arthritis of the hand.

Tremors

You are probably aged over 70 and notice a tremor in the hands; you may have stiffness in the arms and legs; move slowly, hesitate when starting a movement and have poor balance and coordination. Ask your doctor to rule out Parkinson's disease.

Broken hand/wrist/finger

You hear a snap or grinding nose when the injury occurs, there is bruising and swelling around the injured part. It is severely painful to move; there may be an obvious deformity such as a crooked finger, a bent wrist or a broken bone may poke out of the skin. See your doctor straight away, delaying treatment can lead to poor healing and a risk of decreased motion in the future.

Sprain hand/wrist/finger

Wrist sprains means the ligament of the wrist are stretched or torn. Sprains are the most common injury of the hand, they usually occur when someone falls and uses their hand to break their fall. Typically there will be pain, swelling and tenderness over the wrist within a few hours. The wrist will be red and warm to touch. You will probably find it difficult to move the wrist and there may be some bruising. Contact your doctor to rule out a broken bone. Treatment for a sprain usually involves rest and painkillers.

Strain hand/wrist/finger

A strain means the muscle of the hand are injured, this can occur in the same way as a sprain (someone uses their hand to break a fall). It is nearly impossible to tell the difference between a strain and a sprain, basically the affected area will be bruised, inflamed, stiff, painful and sore to touch. See, how to treat a sprain.

Itchy Blisters

Severe itching of the hands, between the fingers or back of elbows that occurs at night and makes sleep impossible. Small raised spots/blisters. You may have scabies.

ARMS

Stiff arm and shoulder: You shoulder is painful and tender to touch, it especially hurts when reaching or lifting; pain spreads down the arm; there is weakness when you lift your arm straight out to the side. These are signs of a condition called painful shoulder. It indicates a problem with the shoulder joint or tendons that could have been caused by injury or arthritis. Talk to your doctor about having an X-ray to narrow down the diagnosis.

Shooting pain

You experience shooting pain in the shoulder which spreads down the arm; pain may be worse after long periods of standing or sitting or when you sneeze or cough. You may have cervical spondylosis.
This is osteoarthritis of the cervical (neck) spine. You might also notice neck stiffness over time and more frequent headaches.

Pain worse after repetitive motion

Pain worsens when you repeat a motion (like clicking your computer mouse); there may also be stiffness, tenderness, tingling and loss of strength. You could have repetitive strain injury (RSI) which is a general medical term for strains. If only the hand is affected, a more specific diagnosis is possible, that is, carpal tunnel syndrome (see hand conditions above). Initially RSI symptoms subside when you stop working, but if it remains untreated it can worsen over time. Treatment options include rest, wearing a splint, physiotherapy and NSAID anti-inflammatories.

Elbow Pain

Pain is located on the outside of the elbow just by the bony lump, it can radiate down to the wrist. This is known as tennis elbow because it is a common injury in tennis players although any repetitive action that requires twisting, such as twisting a screwdriver, can cause it. Tennis elbow is a type of repetitive strain injury. However, if the pain is located on the inside of the elbow it is called golfers elbow - that is, because golfers tend to suffer injury in this area. Ice packs, ibuprofen can reduce inflammation, or if pain does not settle steroid injections are an option.

Arm and chest pain

Stabbing, squeezing pain which starts in the chest and radiates down the arm; pain can last 20 minutes although it may come and go; you may have difficulties breathing, start sweating or feel nauseous. Seek emergency medical care, you could be having a heart attack. See signs of a heart attack.

Arm weakness and slurred speech

Your arm, face or leg on one side of the body suddenly become numb or weak; you have difficulties talking and your speech is slurred; you have problems seeing through one or both eyes, and have difficulties walking. Seek emergency medical care, you could be having a stroke. See signs of a stroke.

Broken Arm

You hear a snap or grinding nose when the injury occurs, there is bruising and swelling around the injured part. It is severely painful to move; there may be an obvious deformity compared to the other arm. See your doctor straight away, you have a broken bone. Delaying treatment can lead to poor healing and a risk of decreased motion in the future. Most fractures will need to have a splint or cast to heal properly.

Sprained Arm

You have stretched or torn ligaments in your arm - this is known as a sprain. You may have sprained your arm by falling awkwardly; the arm appears swollen, is painful and difficult to move. The affected area will be warm and sore to touch. Your doctor may recommend wearing a sling to provide some pain relief until the sprain heals.

Strained Arm

You have stretched or torn muscles/tendons in your arm, perhaps due to an awkward fall. It is nearly impossible to tell the difference between a strain and a sprain in the arm, basically the strained area will be bruised, inflamed, stiff, painful and sore to touch. Your doctor may recommend wearing a sling to provide some pain relief until it heals.

LEGS

Swollen ankles and breathlessness: The legs, feet or ankles become puffy, particularly after a long day standing. If you press down on the swollen skin, your finger mark will remain indented for a few minutes (pitting edema); you also feel breathless and find physical activity exhausting. See, symptoms of heart failure.

Shooting pain down the back of the leg

You have a shooting pain which goes down the back of one leg; pain usually builds up slowly and can persist for days or weeks; it may be particularly worse after standing or sitting for long periods; or at night time or when you sneeze or laugh. You could have sciatica. See, back problems.

Cramps and swelling

Pain or tenderness in one leg which feels like a persistent cramp; the leg might also be swollen. You could have venous thrombosis, also known as deep vein thrombosis (DVT). This is where a blood clot occurs in a deep vein, usually after periods of immobility, for example after a long haul flight. DVT can be dangerous if the clot breaks away and moves towards the lungs where it can cause a fatal pulmonary embolism. Pregnant women, women taking the oral contraceptive pill and women who have had recent hip surgery have a slightly higher risk of DVT.

Enlarged veins

There are visible enlarged veins in the leg; the legs feel heavy and ache, there may also be some discoloration of the skin around the ankles. This condition is called varicose veins. Jobs which require you to stand for long periods of time can make you more vulnerable, as can pregnancy. See, varicose veins in pregnancy and how are varicose veins treated?

Uncontrollable urge to shake leg

Creeping, pulling, throbbing or other sensation in the legs that causes you to move or shake them. Symptoms usually occur at night when the person is trying to sleep; moving the leg temporarily relives discomfort. This is known as restless leg syndrome (RLS) - or in some places as charlie horse. In most cases the cause is unknown although it does tend to run in families. There is no known cure, it is a lifelong condition, although certain medications may help relieve symptoms.

Clumsiness in legs

Clumsiness in moving the legs; numbness or tingling in the arms and legs; unsteadiness when walking and blurred vision. Talk to your doctor to rule out multiple sclerosis.

Stiff knee

Your knee becomes difficult to bend, stiff and swollen; symptoms are worse in the morning or after climbing the stairs. See, knee arthritis.

Shinbone pain

The shinbone (the bone at the front of the lower part of the leg) feels 'crunchy' when you walk or run, there is a feeling of a lump or gap at the location. Typically it occurs in runners who run on hard surfaces, pain ranges from mild discomfort to severe pain. This condition is shin splints. It can radiate down to the ankles (where it is called ankle splints). Rest and ice packs to the affected area usually relieve symptoms. See, how to treat shin splints.

Pain when walking

Pain occurs in one or both legs when you walk and disappears with rest; pain occurs when blood supply is decreased due to a narrowing of the blood vessels in the legs. This condition is called peripheral artery disease (PAD). Other signs of PAD include skin infections and wounds in the legs which are slow to heal. PAD increases your risk of coronary heart disease and stroke significantly (if the veins in the legs are blocked, chances are the heart and neck ones are too). Talk to your doctor about heart disease testing and vascular screening.

Broken Leg

You hear a snap or grinding nose when the injury occurs, there is bruising and swelling around the injured part. It is severely painful to move; there may be an obvious deformity and the broken leg appears shorter than the other leg. See your doctor straight away, delaying treatment can lead to poor healing and a risk of decreased motion in the future. Most leg fractures will need to have a splint or cast to heal properly. Occasionally corrective surgery is required.

Sprained Leg/Knee

The most common type of leg sprain is to the knee (pulled ligament). You may hear a pop noise in your knee at the time of injury; the knee will be swollen within a few hours and there may be inflammation and bruising. The knee will buckle under you if you try to stand on it. Minor sprains heal within 4 weeks, but severe torn muscles or tendons can take up to 12 months to heal. Occasionally corrective surgery is required.

Strained Leg/Knee

The most common type of leg strain is a strain in the knees (pulled muscle or tendon). Symptoms are almost identical to a knee sprain, you may hear a pop noise in your knee at the time of injury; the knee will be swollen within a few hours and there may be inflammation and bruising. The knee will buckle under you if you try to stand on it. Minor strains heal within 4 weeks, but severe torn muscles or tendons can take up to 12 months to heal. Occasionally corrective surgery is required.

Hip Fracture

Fractures are another word for a broken bone. Hip fractures tend to occur in the elderly; the most common symptom is pain in the hip area when walking. It can spread to the buttocks, thighs, knees, groin and back. You may begin to limp and sometimes one leg can look shorter than the other. See, hip fractures. Women with brittle bones, are more prone to 'fragility' fractures; see also osteoporosis.

FEET

Change in skin color: Skin on the toes and/or fingers change color when you are cold; there may also be numbness, pain and tingling. These are signs of Raynaud’s phenomenon. It is caused by constriction of tiny blood vessels when exposed to the cold. In 90 percent of cases it does not indicate an underlying disease.

Brittle nails and swollen ankles

Your ankles are swollen; your toe-nails are brittle; you are tired and short of breath and crave strange foods (see pregnancy cravings - pica, although you are not pregnant). You may have anemia. If you also have tingling in the fingers or toes and loss of balance you may be deficient in vitamin B12.

Bumps on the toes

Bony lump on the edge of the big toe, it may be red with calloused skin; the big toe is turned in towards the other toes; it can be painful if squeezed into shoes. This is a bunion. Bunions can run in the family, or they may be caused by years of wearing high-heeled, narrow-toed shoes. If a bunion starts to form you will need to switch to wide-measured shows. If it worsens and pain becomes unbearable, a bunionectomy (surgery to remove the lump) can be effective.

Numbness with diabetes

If you are diabetic and you start to lose sensation in your feet, this may be a sign of diabetic neuropathy, or nerve damage. Talk to your doctor immediately, as this is one of the leading causes of foot amputations in the United States. See, diabetes complications.

Flaky skin between toes

Scaling flaky skin between the toes which may be itchy, peel and bleed. This is a fungal infection called athletes foot. It is possible to pick athletes foot up from a shower floor after someone with the condition has used it. There are over the counter remedies for treating the condition, if it does not clear up ask your doctor to prescribe something stronger.

Broken Ankle/Foot

Pain from a broken ankle may not come from the point of injury, it can appear for example on the side of the small toe (known as 'referred pain'); the ankle becomes swollen and there is bruising which can start in the ankle and end in the toes. There may be some deformity of the ankle, a bone can be exposed or protrude through the skin. If the toe is broken, there may be some deformity, for example it may look bent out of shape. There will be bruising, swelling and stiffness and it will be almost impossible to wear shoes. Both injuries need immediate medical attention.

Sprained Ankle/Foot

If the ankle or toe is sprained, there is swelling and pain; pain worsens when the ankle/toe is touched or when walking/standing. There is inflammation and the affected area is hot to touch. Usually a sprain heals naturally within 2 weeks, if pain worsens, contact your doctor.

Growth on heel

Growth of bone at the back of the heel, or beneath the sole of the foot; it can cause tenderness and pain in the area which is worse when you push on the ball of the foot. This is called a heel spur. Mostly there is no obvious cause, although sometimes spurs are related to arthritis. If pain is persistent your doctor may recommend cortisone injections.